There are a number of surgical devices utilized by surgeons that deliver one or more types of energy to cut, coagulate, ablate, remove or otherwise treat tissue of a patient. Surgical energy devices include ultrasonic devices, electrosurgical devices utilizing monopolar and/or bipolar RF (Radio-Frequency) current, microwave and/or thermal energy devices, and higher-frequency electromagnetic radiation delivery devices such as lasers. Such surgical energy devices are utilized by themselves in some surgical techniques and, in other techniques, are utilized in combination with one or more other tools such as forceps or graspers.
Examples of medical laser systems utilizing hollow waveguides are provided by Temelkuran et al. in U.S. Pat. Nos. 7,167,622 and 7,331,954, and by Goell et al. in U.S. Pat. No. 8,280,212, all assigned to OmniGuide, Inc. of Cambridge, Mass. For sterility, safety and quality assurance purposes, each waveguide is utilized for only a single surgical procedure. At the beginning of a procedure, a single-use waveguide is inserted into a reusable handpiece which is graspable by a surgeon.
Many surgical instruments have been designed to bend in multiple directions to assist insertion and to manipulate tissue. An intraluminal manipulator is disclosed by Ortiz et al. in U.S. Pat. No. 5,346,504. Arthroscopic and endoscopic instruments with articulating shafts are described by McMahon in U.S. Pat. No. 5,467,763 and by Aust et al. in U.S. Pat. Nos. 5,454,827 and 5,540,706. An instrument with positive and non-positive linking of segments, for insertion into body cavities, is presented by Heckele in U.S. Pat. No. 5,448,989. Articulated and steerable tips of endoscopic devices and cannulas for robotic surgery are disclosed by Bonneau and by Prisco et al. in U.S. Patent Publication Nos. 2009/0171332 and 2010/0249507, respectively, and by Vargas in U.S. Pat. No. 8,075,476, for example.
A difficulty in targeting desired tissue may arise when utilizing a non-visible energy beam such as a CO2 laser beam. Positioning of an ultrasonic beam utilizing one or more light sources is disclosed by McCarty in U.S. Pat. No. 5,107,709. It is also known to align non-visible laser beams utilizing phosphor screens available from LUMITEK International, Inc. of Ijamsville, Md., especially for bench testing and research purposes. Visible aiming beams utilized with CO2 lasers are described by Michael Black in U.S. Pat. No. 5,420,882, by Temelkuran et al. in U.S. Pat. No. 7,331,954, by Shapira et al. in WO2006/135701 and by Gannot et al. in U.S. Patent Publication No. 2006/0052661, for example. However, there remains a need to optimize tissue treatment under actual conditions which may vary from patient to patient, and may vary among different tissues and locations within each patient.
It is therefore desirable to have an improved system and method to effectively access and treat selected tissue within a patient utilizing surgical energy devices.